Behavioral Activation and Medication Optimization for Perioperative Mental Health in Orthopedic Surgery
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 116
- 试验地点
- 1
- 主要终点
- PHQ-ADS
研究概览
简要总结
This Hybrid 1 Study will test the effectiveness of a bundled intervention comprised of behavioral activation and medication optimization in reducing symptoms of depression and anxiety in older adults undergoing Orthopedic surgery (compared with usual care), while examining implementation outcomes.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Investigator, Outcomes Assessor)
盲法说明
Study staff responsible for administering ratings and collecting outcomes throughout the study are blinded. The investigator(s) are also blinded. This blinding is kept throughout the study until data collection is complete. At the end of the follow-up, the study coordinator will complete a blinding question to try to guess the arm to which each participant was allocated.
入排标准
- 年龄范围
- 60 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adults ≥ 60 years
- •Scheduled primary hip or primary knee arthroplasty procedure
- •PHQ-ADS ≥ 10, indicating clinically significant depression or anxiety symptoms
排除标准
- •Barrier to communication (Unable to read, speak, and understand English)
- •Severe cognitive impairment screened by the SBT (Short Blessed Test) >10
- •Acutely suicidal
- •Previous participation in this study or another CPMH study of the intervention bundle or its feasibility.
研究组 & 干预措施
Behavioral activation and medication optimization
Behavioral activation (BA) will begin perioperatively and will span across 3 months postoperatively, with sessions approximately weekly or biweekly, depending on patient preference & health condition.
Medications will be reviewed by a team of interventionists to minimize brain-toxic medications and optimize doses of antidepressants and other mental health medications. In-hospital and after discharge, the interventionists' role will include coordinating with the care teams to ensure that medication changes that were introduced preoperatively are maintained.
干预措施: Behavioral activation (Behavioral)
Behavioral activation and medication optimization
Behavioral activation (BA) will begin perioperatively and will span across 3 months postoperatively, with sessions approximately weekly or biweekly, depending on patient preference & health condition.
Medications will be reviewed by a team of interventionists to minimize brain-toxic medications and optimize doses of antidepressants and other mental health medications. In-hospital and after discharge, the interventionists' role will include coordinating with the care teams to ensure that medication changes that were introduced preoperatively are maintained.
干预措施: Medication optimzation (Other)
Control (treatment as usual)
Participants in control arm will continue care as usual. They will receive printed resources for supporting sleep hygiene, stress reduction, cognitive and mental health exercises, as well as community resources for older adults.
干预措施: Care as usual (Other)
结局指标
主要结局
PHQ-ADS
时间窗: 3 months post-operatively
PHQ-ADS (Patient Health Questionnaire Anxiety and Depression Scale) scores will be compared between the two study arms 3 months after surgery. PHQ-ADS is a composite measure of anxiety and depression. PHQ-ADS scores can range from 0 to 48 (with higher scores indicating more severe depression/anxiety)
PHQ-ADS (Patient Health Questionnaire Anxiety and Depression Scale)
时间窗: Baseline and 3 months post-operatively
Change in PHQ-ADS (Patient Health Questionnaire Anxiety and Depression Scale) scores from baseline to 3 months postoperatively will be compared between the two study arms 3 months after surgery. PHQ-ADS is a composite measure of anxiety and depression. PHQ-ADS scores can range from 0 to 48 (with higher scores indicating more severe depression/anxiety)
次要结局
未报告次要终点
研究者
Ryan Calfee, MD
Professor of Orthopaedic Surgery
Washington University School of Medicine